HomeMy WebLinkAbout1707 C StELECTRICALPERMM
CTIY OF PORT ANGELES
360-417-4735
INDUSTRIAL HEAiV.Y
0
REPORT STATE SALES TAX
on your excise tax form
to the City of Port Angeles
(Location Code 0502)
tr'!
o
=\-LAppLication Number
Application pin number
Property Address
ASSESSOR PARCEL NUIiIBER:
Appli.cation tsy'pe descriptsion
SuMivision Name .. .
Property ose
Property zoning
Applicaiion vafuatsion,
19- 00001054 Date ? /1-5/19
6220L0
1707 C ST
o5-30 - 00- 0-4 -4900- 0000-
EIJECTRICA! ONIJY
Applicatlon desc
New salt shed power
Contslactor
STATE OF WASHINGTON
GEN ADMIN
OL1'}'1PIA
OWNER
wA 985041000
Pernit
Additional desc
Permit. Fee
fssue Date
Expira!ion Date
'74 . a0
'7 /ts/t9!/tt/20
EIECTRICAL ALTER COMMERCIAL
Plan Check Fee
valuation
.00
0
Qty Unit Charge per
1.00 74.0000 EcH EL-COMM BRANCH CIR WO/ S/F
Extension
74.OO
Permit Fee Total
PIan Check Total
Grand Total
74.04
.00
'74 .00
74-00
.00
74 .00
00
00
00
00
00
00
PERMIT WILL EXPIRE Slx (6) MONTHS FROM LAST NSPECTION
INSPECTION TYPE DATE:RESULTS INSPECTOR:
DITCH tln)ft .R .=ffi
SERVICE
ROUGH.IN elil ln N @
FINAL a)il lq I 4
COMMENTS:
Sigmture ofoqmer or Electrical Contractor X Dale:
:i::Y:i -"::1i _:::11::i- _.. T:
MULTI-FAM ILY / COMMERCIAL
ELECTRICAL PERMITAPPL ICATION
Public Works and Utilities Department
321 E. sth Street, Port Angeles, WA 98362
360.417.4735 www.cityofpa.us electricalpermits@cityolpa.us
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-DProject Address
Project Description
E Multi-Family Residential g Commercial
Name
ublic Building Square footage
Email 'Lpa,
lvlailing Address P hone 3h-1-,7qo-ofrQ
ndustri
O!\NER INFORMATION
ELECTRICAL CONTRACTOR INFORMATION
Name
Mailing Address
Email:
License
Expiration Date
Phone:
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201 400 Amp
Service/Feeder 401500 Amp.
Service/Feeder 601-'1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. Se.vice/Feeder 201-400 Amp
Temp. Service/Feeder 401600 Amp.
Temp. Service/Feeder 601-1000 Amp.
Portal to Portal Hourly
Sign / Outline Lighting
Signal CircuivLimited Energy - Multi-Family
Signal CircuiVLimited Energy/First 1500 sf - Commercial
(Note: $5.00 foreach additional 1500 s0
Renewable Elec. Energy: 5KVA System or less
Thermostat (Note: $5 for each additional)
Quantitv TOlal(Quantity x Unit Charge)Unit Cha.oe
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$5.00
$86.00
$102.00
$121.00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
l
$
$
$
$
$
$
$
$
$
$
$
s
$
$
$
$
$
$
$
q
$113 00
$s6.00
1.1 2 TOTAL
Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is
required to hire an electncal contractor if above said property as for sale, rent or lease Permit expires after six months of last inspection.
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor I
am making the electrical installation or alteration in compliance with the electrical laws, N. E.C., RCW Chapter 19.28, WAC. Chapter 296-
468, The City of PortAngeles MunicipalCode, and Utility Specilications and PAMC 14.05.050 regarding Electncal Permit Applications.
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Date Print Name Signature (fl Owner ! Electrical Contractor / Administrator)
lElectrical Permit Applications may be submitted to City Hall or epermits@cityofpa. us or faxed to 360.417.471 1l
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